Promising benefit of resveratrol in preventing preterm birth: A systematic review

Abstract

Prematurity is a matter of utmost concern in pregnancies due to its associated complications, mortality, disability and significant economic burden. However, the current tocolytics used for preventing preterm birth have limitations, such as side-effects and unclear inhibitory pathway mechanisms. Hence, it is critical to explore alternative tocolytics, such as resveratrol. The present study, by performing a systematic review, aimed to investigate the potential of resveratrol in preventing prematurity and its therapeutic applications. A systematic search of the relevant literature was conducted using advanced search engines (PubMed, ProQuest, EBSCOhost and EMBASE), employing specific key words and predefined eligibility criteria to identify supporting articles, which were subsequently synthesized into the systematic review. Of note, four critical lines of evidence, supported by multiple studies, highlight the promising benefits of resveratrol in preventing preterm birth. In a mouse model of preterm birth, resveratrol has demonstrated the ability to: i) Reduce prematurity rates by 49-64%; ii) inhibit inflammatory mediators and cytokines (nitric oxide synthase, inducible nitric oxide synthase, cyclooxygenase (COX)-2 in the uterus, TNF-α, IL-1β, COX-2 in peritoneal macrophages and the cervixs; iii) decrease prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) levels in the uterus; and iv) regulate endocannabinoids (anandamide and 2-arachidonoylglycerol) and endocannabinoid-like lipids. By reducing the levels of these substances, resveratrol has the potential to prevent cervical ripening, membrane rupture and myometrial contractility associated with preterm birth. In summary, resveratrol offers multiple pathways to inhibit inflammation-induced prematurity, rendering it a promising candidate as a novel tocolytic agent.